The Study Of Homocysteine And High Sensitivity C-reactive Protein In Acute Ischemic Stroke Patients With Carotid Stenosis

Objective:To study the relationship between the plasma homocystine(HCY), high-sensitive-reactive protein (hs-CRP) and carotid artery stenosis in acute ischemic stroke patients.Methods:Selected178cases of acute ischemic stroke patients (onset<7days),all cases diagnosed in line with the revised diagnostic criteria of the Fourth National Cerebrovascular Disease Conference. Within2days after admission, take venous fasting blood to test HCY/hs-CRP from178cases patients of acute ischemic stroke.178cases was divided into carotid artery stenosis group and non-carotid artery stenosis group by cervical vascular ultrasound, which contained103cases and75cases respectively, and then divided the carotid artery stenosis group into3subgroups as experimental group.33cases of mild stenosis,36cases of moderate stenosis and34cases of severe stenosis. Control group contained37cases which were the same period of hospitalized patients in our hospital.Results:1.The detection rate of carotid artery plaque was81.46%and carotid artery stenosis was57.86%in the178cases of the acute ischemic stroke patients, there was significant difference,P<0.01;which was higher than the control group, especially in the mild and serve groups which has hemodynamic changes, the difference was statistically significant, P<0.01.2.The serum HCY content in the soft plaque group and mixed plaque group was higher than the hard plaque group respectively. P<0.01.Serum hs-CRP content among the three carotid artery plaque groups was significant differences between each other, P<0.05或P<0.01.3.In ischemic stroke patients who with carotid soft plaque or mixed plaque.the content of serum HCY and hs-CRP was higher than the patients with carotid hard plaques, the difference was statistically significant, P<0.05.4.The content of HCY and hs-CRP in mild/moderate and severe carotid stenosis patients with ischemic stroke were higher than the control group, P<0.05.5. Among the three carotid artery stenosis groups, pairwise comparisons of serum HCY content was statistically significant difference,P<0.05; compared with severe stenosis group, the content of hs-CRP of mild and moderate stenosis group was statistically significant difference,P<0.05.Conclusions:1.The detection rate of carotid artery plaques and stenosis in acute ischemic stroke patients was higher than in the control group, the difference was statistically significant, which demonstrated that carotid artery stenosis is an important cause of acute ischemic stroke and carotid artery stenosis is closely related to atherosclerotic plaque.2.The contents of serum HCY and hs-CRP among the soft plaque group\mixed plaque group and hard plaque group were statistically significant difference, which demonstrated that there was different degrees of inflammation and immune response in the pathogenesis of ischemic stroke.3.Among the acute ischemic stroke, the contents of serum HCY and hs-CRP in patients who with soft plaque/mixed plaque were higher than patients who with hard plaque, the difference was statistically significant, which demonstrated that the content of serum HCY and hs-CRP was gradually downward with the stability of carotid artery plaque.4.The contents of serum HCY and hs-CRP among the mild/moderate/severe stenosis groups were difference when compared with control group respectively, which demonstrated that the contents of serum HCY and hs-CRP were closely related with acute ischemic stroke who with carotid artery stenosis.5.Among the three carotid artery stenosis groups, pairwise comparisons of serum HCY content was statistically significant difference; compared with severe stenosis group,the content of hs-CRP of mild and moderate stenosis group was statistically significant difference. which demonstrated that the contents of serum HCY and hs-CRP were positively correlated with the degree of stenosis of the carotid artery, the more severe stenosis of carotid artery.the higher of content of serum HCY/hs-CRP.